UTILIZATION OF KING’S INTERACTING SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT WITH NEW MULTIDISCIPLINARY MODEL: CLINICAL PATHWAY

Abstract

Background: The critical role of research in nursing practice is the application of nursing theories to discover new knowledge. This study uses King’s interacting systems framework and theory of goal attainment to investigate the effectiveness of implementing clinical pathways for patients undergoing transurethral resection of prostate (TURP) at Aga Khan University Hospital (AKUH), Pakistan.

Objective: To assess the impact of the implementation of a clinical pathway for the surgical procedure of TURP on clinical quality, cost, and patient and staff satisfaction.

Study Design: Quasi-experimental, non-equivalent control group study design using clinical pathway intervention.

Setting: Aga Khan University Hospital (AKUH).

Subjects: The study population consisted of a convenience sample of patients undergoing surgery for TURP (control and experimental) and health team members (nurses, physicians and others).

Study Findings: Findings showed a significant difference in variances and outcomes as a result of TURP clinical pathway intervention. The clinical pathway significantly improved all twelve nursing and physician related variances and outcomes, such as: complete documentation; delayed consultation; delayed education; and other variances. Clinical pathway intervention also significantly reduced hospital related variances, and post-operative problems such as electrolyte imbalance, phlebitis, constipation, and urinary tract infection (UTI). The findings also showed significant improvement in patient and staff satisfaction, however no significant difference was observed in patient, hospital and financial related variances. The current investigation identified that successful implementation of integrated clinical pathways can help health professionals, managers and administrators to meet one of their biggest challenges in making optimal use of limited resources while delivering high quality and timely care.